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["Request for Dental Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["Arlington County Government hereinafter referred to as \"County\""]
["Dental Technical Instructions"]
["Questionnaire/Terms and Conditions"]
[]
["1.0  INTENT"]
["Arlington County Government is seeking proposals from qualified organizations to provide administration of the current DPPO programs for their active employees, retirees under 65, and COBRA participants effective July 1, 2021. ",{"$nulls":7},"07/08/2020 -- All Retirees over and under 65 participate in dental plans ","updated"]
[]
["Quotes are requested on the following self-insured plans:"]
["County","County"]
["Premium Plan Delta Dental PPO\n(Active | U65 Retiree & O65 Retiree)","Standard Plan Delta Dental PPO\n(Active | U65 Retirees & O65 Retiree)",{"$nulls":6},"07/08/2020 -- All Retirees over and under 65 participate in dental plans ","updated"]
[]
[]
["Additional information you are required to provide must be submitted using the appropriate worksheets in this RFP. A listing of these additional worksheets is shown below.  You must complete the worksheets in this RFP file, as specified, and provide the required attachments by the deadline to have a completed proposal submission."]
["Important: As a reminder, please provide complete responses in your RFP submission as there will be no requests for clarification and your responses will be scored according to how you reply to each question and on requested materials provided."]
[]
["In order to help you organize your proposal and ensure that it is complete, please review the following list to ensure that you have provided each required item. "]
["Part 1. Questionnaire File:"]
["Information",null,null,"Name of Worksheet"]
["Introduction",null,null,"Intro"]
["Questionnaire                                                                             ",null,null,"Questionnaire"]
["Explanations, if necessary                                                    ",null,null,"Explanation"]
["Plan Design Instructions",null,null,"Plan Design Instructions"]
["Standard Plan Design",null,null,"Standard Plan Design "]
["Premium Plan Design",null,null,"Premium Plan Design"]
["Geo Access Insructions",null,null,"Geo Access"]
["Provder Disruption Instructions",null,null,"Disruption"]
["Plan Documents",null,null,"Plan Documents"]
[]
["2.0 CURRENT DENTAL PLAN DESIGNS"]
["A brief description of current coverages for each Group is reflected on the Plan Design worksheets.   Please quote the plan(s) as noted in the plan design worksheets.  Carriers must explicitly and clearly delineate any deviations between the coverage being offered and the current plan coverage as contained in this RFP and supporting attachments, if applicable.  In the absence of such directions, the proposal will be considered a warranty agreement to provide the plan provisions, as specified in this RFP.  Detailed plan information can be found in attached plan documents, referenced within this RFP. "]
["The insurer must provide coverage on a discontinuance and replacement basis (sometimes referred to as a \"no loss/no gain\" basis) for eligible employees participating in the current plans on the effective date."]
[]
["3.0 CURRENT PLAN PARTICIPATION"]
["The Charts below summarizes the plan participation in contract lives (Medicare Retirees included as members unless otherwise noted) for each County.  Refer to the census files for detailed information."]
[]
["Classes/Groups","Actives","Retirees"]
["County"]
["Standard PPO",{"$f":"2484","v":{"v":2484,"d":"2,484"}},{"v":1608,"d":"1,608"}]
["Premium PPO",793,194]
["Total Lives",{"$f":"SUM(B39:B41)","v":{"v":3277,"d":"3,277"}},{"$f":"SUM(C39:C41)","v":{"v":1802,"d":"1,802"}}]
[]
["4.0 CONTRIBUTION LEVELS"]
["The following describes the ACTIVE EMPLOYEE contributions for the coverages included in this marketing:"]
["Coverage","Standard","Premium"]
["Full time (30-40 hours/week)"," EE %"," EE %"]
["Single",{"v":0.2,"d":"20%"},{"v":0.5,"d":"50%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.25,"d":"25%"},{"v":0.5,"d":"50%"}]
["Employee + Child(ren)",{"v":0.25,"d":"25%"},{"v":0.5,"d":"50%"}]
["Family",{"v":0.25,"d":"25%"},{"v":0.5,"d":"50%"}]
[]
["Part time (20-29 hours/week)"," EE %"," EE %"]
["Single",{"v":0.5,"d":"50%"},{"v":0.75,"d":"75%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.5,"d":"50%"},{"v":0.75,"d":"75%"}]
["Employee + Child(ren)",{"v":0.5,"d":"50%"},{"v":0.75,"d":"75%"}]
["Family",{"v":0.5,"d":"50%"},{"v":0.75,"d":"75%"}]
[]
["Part time (10-19 hours/week)"," EE %"," EE %"]
["Single",{"v":0.7,"d":"70%"},{"v":0.9,"d":"90%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.7,"d":"70%"},{"v":0.9,"d":"90%"}]
["Employee + Child(ren)",{"v":0.7,"d":"70%"},{"v":0.9,"d":"90%"}]
["Family",{"v":0.7,"d":"70%"},{"v":0.9,"d":"90%"}]
[]
["The following describes the RETIREE contributions for the coverages included in this marketing:"]
["Coverage","Standard","Premium"]
["GROUP 1:\nChapter 21: 20+ yrs svc;\nChapter 46: 25+ yrs svc","RETIREE %","RETIREE %"]
["Single",{"v":0.19994566693833196,"d":"20%"},{"v":0.5,"d":"50%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.19997281131049485,"d":"20%"},{"v":0.5,"d":"50%"}]
["Employee + Child(ren)",{"v":0.2,"d":"20%"},{"v":0.5,"d":"50%"}]
["Family",{"v":0.1999821762766242,"d":"20%"},{"v":0.5,"d":"50%"}]
[]
["GROUP 2:\nChapter 46: 23-24 years of service","RETIREE %","RETIREE %"]
["Single",{"v":0.25998370008149957,"d":"26%"},{"v":0.54,"d":"54%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.26005981511691134,"d":"26%"},{"v":0.54,"d":"54%"}]
["Employee + Child(ren)",{"v":0.26004993757802747,"d":"26%"},{"v":0.54,"d":"54%"}]
["Family",{"v":0.2599590054362357,"d":"26%"},{"v":0.54,"d":"54%"}]
[]
["GROUP 3:\nChapter 46: 20-22 years of service","RETIREE %","RETIREE %"]
["Single",{"v":0.35995653355066554,"d":"36%"},{"v":0.6,"d":"60%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.35997824904839587,"d":"36%"},{"v":0.6,"d":"60%"}]
["Employee + Child(ren)",{"v":0.3600499375780275,"d":"36%"},{"v":0.6,"d":"60%"}]
["Family",{"v":0.3600392121914268,"d":"36%"},{"v":0.6,"d":"60%"}]
[]
["GROUP 4:\nCh 21 & 46: 15-19 years of service","RETIREE %","RETIREE %"]
["Single",{"v":0.52,"d":"52%"},{"v":0.7,"d":"70%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.52,"d":"52%"},{"v":0.7,"d":"70%"}]
["Employee + Child(ren)",{"v":0.5199750312109863,"d":"52%"},{"v":0.7,"d":"70%"}]
["Family",{"v":0.5200071294893504,"d":"52%"},{"v":0.7,"d":"70%"}]
[]
["GROUP 5: \nCh 21 & 46: 10-14 years of service","RETIREE %","RETIREE %"]
["Single",{"v":0.68,"d":"68%"},{"v":0.8,"d":"80%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.68,"d":"68%"},{"v":0.8,"d":"80%"}]
["Employee + Child(ren)",{"v":0.68,"d":"68%"},{"v":0.8,"d":"80%"}]
["Family",{"v":0.68,"d":"68%"},{"v":0.8,"d":"80%"}]
[]
["GROUP 6:\nCh 21 & 46: 0-9 years of service","RETIREE %","RETIREE %"]
["Single",{"v":0.84,"d":"84%"},{"v":0.9,"d":"90%"}]
["Employee + Spouse or\nAdult Dependent",{"v":0.84,"d":"84%"},{"v":0.9,"d":"90%"}]
["Employee + Child(ren)",{"v":0.84,"d":"84%"},{"v":0.9,"d":"90%"}]
["Family",{"v":0.84,"d":"84%"},{"v":0.9,"d":"90%"}]

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["Request for Dental Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["Arlington County Government hereinafter referred to as \"County\""]
[]
[]
["",""]
["","",null,"Dental RFP","Answer Format","Response","Explanation"]
["",""]
["I","",null,"General Plan Information"]
["","1.","","Network Plan Name","text"]
["","2.","","Network Model Type","drop down box"]
["","3.","","Network Operational Date","# of years"]
["","4.","","Total network PPO membership as of 1/1/2020","number, 0"]
["","5.","","Total network PPO membership as of 1/1/2019","number, 0"]
["",""]
["II","","","PLAN DESIGN"]
[null,"1.","","The County is requesting that vendors duplicate the current plan design offerings.  Please indicate (yes/no) if your organization is quoting on a specific plan.  If the plan you are quoting matches current in every way, indicate \"NO DEVIATIONS\" in your response.  Otherwise, list your deviations in the appropriate space provided.  Note that vendor may elect to quote on or more of the following plans:"]
["",null,"a.","County:  Please see attached plan documents for detailed plan information"]
[{"$nulls":3},{"$f":"Introduction!A12","v":"Premium Plan Delta Dental PPO\n(Active | U65 Retiree & O65 Retiree)"},"drop down box"]
[{"$nulls":3},{"$f":"Introduction!B12","v":"Standard Plan Delta Dental PPO\n(Active | U65 Retirees & O65 Retiree)"},"drop down box"]
["","2.","","Include a concise description of how your organization covers dental transition of care conditions, if a new member is receiving treatment from a non-participating provider.  Name the file:  [Your Organization's Name]_Transition of Care.","drop down box"]
["","3.","","Include a description of any and all standard benefit exclusions.  Name the file:  [Your Organization's Name]_Benefit Exclusions.","drop down box"]
["","4.",null,"What is the suggested pre-determination of benefits threshold amount?","dollar, 0"]
[]
["III",null,null,"Financial - Program Fees and Claims Substantiation"]
[null,"1.",null,"For self-insured invoices, claims billed must provide backup data in an Excel format to reconcile claims paid to eligible subscribers/members. Data fields to include at a minimum:  First name, last name, subscriber relationship, subscriber ID#, patient first name/last name, date of service, claim number, provider charges, total amount paid.","drop down box"]
[null,"2.",null,"For self-insured fees, the County requires the following back up in an Excel format to reconcile admin fees/premiums paid to eligible subscribers. Data fields to include at a minimum:  First name, last name, subscriber ID#, tier, admin fee/premium due.","drop down box"]
[]
["IV",null,"","NETWORK ACCESS/DENTAL NETWORK MANAGEMENT"]
["","1.","","Provider Disruption:  You will request Provider Disruption our NAPD team: hnapdmbx@aon.com. Please follow the workflow requested in the e-mail outlined by the NAPD team.  Confirm you have followed the process and provided the requested data for the County.","drop down box"]
[null,"2.",null,"GeoAccess:  You will request GeoAccess insructions from our NAPD team: hnapdmbx@aon.com. Please follow the workflow requested in the e-mail outlined by the NAPD team.  Confirm you have followed the process and provided the requested data for the County.","drop down box"]
[null,"3.",null,"Reimbursement:  You will request Reimbursement/Discount data from our NAPD team: hnapdmbx@aon.com. Please follow the workflow requested in the e-mail outlined by the NAPD team.  Confirm you have followed the process and provided the requested data for the County.","drop down box"]
["","4.","","Number of General Family Dentists (GFDs) who left the network during 2019 (due to both voluntary and involuntary reasons).","number, 0"]
["","5.",null,"Confirm that, if requested, you are willing and able to add dental providers to your networks.","drop down box"]
["","6.","","What network management services will be delivered by a subcontractor or other outside organizations?  Include leased network arrangements.","text"]
["","7.",null,"Reimbursement - Percent of GFDs' services paid by:"]
["","","a.","Capitation","percentage, 1"]
["","","b.","Fee Schedule","percentage, 1"]
["","","c.","Discounted fees","percentage, 1"]
["",null,"d.","Incentive programs (bonus, withholds)","percentage, 1"]
["","8.",null,"GFDs’ average percent discount. ","percentage, 1"]
["","9.",null,"Percent of specialists who are board certified in network by type:"]
["",null,"a.","Endodontists","percentage, 1"]
["","","b.","Oral surgeons","percentage, 1"]
["","","c.","Periodontists","percentage, 1"]
["","","d.","Prosthodontists","percentage, 1"]
["","","e.","Orthodontists","percentage, 1"]
["","","f.","Other","percentage, 1"]
["",null,null,"Total","percentage, 1"]
["","10.",null,"Reimbursement - % of specialist dentists' services paid by:"]
["","","a.","Capitation","percentage, 1"]
["","","b.","Fee schedule","percentage, 1"]
["",null,"c.","Discounted fees","percentage, 1"]
["",null,"d.","Incentive programs (bonus, withholds)","percentage, 1"]
[null,"11.",null,"Specialist dentist average % discount","percentage, 1"]
[null,"12.",null,"Current Out-of-network UCR reimbursement is based on 85% percentile.  Please confirm what is included in quote.","percentage, 1"]
[null,"13.",null,"You maintain geographically specific reasonable and customary (R&C) charge screens for dental procedures.","drop down box"]
[null,"14.",null,"Your company can provide claims adjudication at varying R&C percentiles beginning with the 50th percentile.","drop down box"]
[null,"15.",null,"Please note the source of your R&C information (e.g., HIAA, MDR, internally developed, other)","drop down box"]
["",""]
["V",null,"","Credentialing and Recredentialing"]
["","1.",null,"During the dentist selection/credentialing process, primary verification is used to check the following items."]
["","","a.","Graduation from an accredited US college of dentistry","drop down box"]
["","","b.","Valid state license (for state of practice)","drop down box"]
["","","c.","Board certification/eligibility appropriate to practice area","drop down box"]
["","","d.","Federal and state DEA controlled substance registration and unrestricted prescribing privileges","drop down box"]
["","","e.","Malpractice coverage","drop down box"]
["","","f.","Detailed malpractice history","drop down box"]
["","","g.","Detailed history of disciplinary action or litigation","drop down box"]
["","","h.","Detailed history of chemical dependency","drop down box"]
["","","i.","Detailed history of general and mental health","drop down box"]
["","","j.","Detailed history of conviction for fraud or felony","drop down box"]
["","","k.","Membership in professional organization","drop down box"]
["","","l.","Regularly scheduled hours at least four days per week","drop down box"]
["","","m.","Availability of chair hours","drop down box"]
["","","n.","Service complaints","drop down box"]
["","","o.","Quality of care complaints","drop down box"]
["","","p.","Member grievances","drop down box"]
["","","q.","Member surveys","drop down box"]
["","","r.","Chart review","drop down box"]
["","","s.","On-site visits","drop down box"]
["","","t.","Emergency training (CPR)","drop down box"]
["",null,"u.","Other (specify)","drop down box"]
["","2.","","Can you state categorically that network management staff conduct primary verification on every participating dentist for each item answered in the affirmative above?","drop down box"]
["","3.","","Your dental plan has a defined program and process to systematically evaluate participating General/Family Dentists (GFDs) for cost, utilization, clinical outcomes, administration cooperation and member services satisfaction.","drop down box"]
["","4.","","General/Family Dentists are not at any financial risk for specialty services.","drop down box"]
["","5.","","As part of the network’s quality assurance program, all GFDs are personally visited by a network staff prior to credentialing in order to assess the dental office environment and interview the dentist.","drop down box"]
["","6.","","All participating GFDs are personally visited by a network staff at least once annually in order to reassess the dental office environment and interview the dentist.","drop down box"]
["","7.",null,"The network’s management information systems routinely collects information on the following items and this information is communicated to the participating dentist at least two times per year."]
["","","a.","Adherence to community standards","drop down box"]
["","","b.","Appropriate use of services","drop down box"]
["",null,"c.","Billing accuracy","drop down box"]
["","8.","","Your organization conducts statistically credible member satisfaction surveys at least annually.  ","drop down box"]
["","9.","","Dentist-specific findings from member satisfaction surveys are shared with the dentist at least once annually.","drop down box"]
["","10.","","Can patient satisfaction results be reported on a client-specific basis?","drop down box"]
["","11.",null,"Indicate those utilization issues your management information system monitors to evaluate the amount and quality of dental care provided:"]
["","","a.","Identifies statistical data on members according to employer group","drop down box"]
["","","b.","Identifies the number of member visits by employer group","drop down box"]
["","","c.","Maintains patient complaints using telephone tracking system","drop down box"]
["",null,"d.","Reports unusual utilization for a given participating dentist.","drop down box"]
["","12.","","Upon request, patients and dentists are informed about the criteria used by the dental plan in approving or denying treatment.","drop down box"]
["","13.","","At least the following dentist-specific database information is available to members by calling the member services department: name, specialties, age, gender, years in practice, board certification, education, fluent languages, hours of operation and number of complaints.","drop down box"]
["","14.","","General/Family Dentists are recredentialed annually.","drop down box"]
[null,"15.",null,"Specialty dentists are recredentialed at least every two years.","drop down box"]
[null,"16.",null,"Are network providers surveyed for their satisfaction levels with network administration?","drop down box"]
[null,"17.",null,"Confirm your organization will proactively provide material network changes to County, including identification of affected membership.","drop down box"]
[null,"18.",null,"Confirm your organization is not or has not been involved in any litigation in which you and/or current or former network providers were joined involving any coverage, quality of care or negligence issues. ","drop down box"]
[null,null,""]
["VI","",null,"CLINICAL AND QUALITY CARE PROGRAMS/HEALTH IMPROVEMENT SERVICES"]
[null,"1.",null,"What is your organization's approach to dental wellness and preventive care?","text"]
[null,"2.",null,"Does your organization offer any special programs which serve to promote dental health and encourage preventive care?  If so, please describe these programs.","drop down box"]
[null,null,"a.","Are there any incentives for enrollees for receiving preventive care?","drop down box"]
[null,"3.",null,"Does your organization offer any disease management programs?  If so, please describe the programs.","drop down box"]
[null,null,"a.","Do you have a diabetes disease management program?","drop down box"]
[null,null,"b.","Do you have a hypertension and high blood pressure disease management program?","drop down box"]
[null,null,"c.","Do you have a pregnancy program available to enrollees?","drop down box"]
[null,"4.",null,"If the above responses are yes, are there any additional charges associated with these programs?  Please include these charges in your financial quotation in your cost proposal.","drop down box"]
[null,"5.",null,"Do you offer reminder letters, emails, and/or texts to employees about preventive dental exams?","drop down box"]
[null,null,"a.","Is the communication electronic?","drop down box"]
[null,null,"b.","Can multiple reminders be sent out each year?","drop down box"]
[null,"6.",null,"Please describe the risk assessment tools that are available to County participants.","text"]
[null,"7.",null,"Does your website provide access to information on dental preventive care?","drop down box"]
[null,"8.",null,"Please describe any limitations regarding the replacement of teeth that are missing when a person first becomes insured.","text"]
[null,"9.",null,"How are dental emergencies handled?  Is there a difference in response between network and non-network providers?","text"]
[]
["VII","",null,"CLAIMS ADMINISTRATION"]
["","1.",null,"Confirm that the claim amount paid will be the negotiated amount.  In other words, services will pay actual negotiated amount; none of the savings will be retained by your organization or shared with any other organization.","drop down box"]
["","2.","","Network dentists routinely submit claims to the network and the claims administrator (i.e. is it a paperless process from the employee's point of view).","drop down box"]
["","3.","","Network members never have to submit claim forms for in-network services.","drop down box"]
["","4.","","Each of your networks serving the County members is supported by a computerized, on-line direct access claims processing system containing plan/claim information storage and retrieval.","drop down box"]
["","5.","","Electronic copies of plan summaries and claims administration are provided ","drop down box"]
["","6.","","All dental procedures are coded using the ADA 4-digit code for in-network claims, out-of-network and out-of-area claims.","drop down box"]
["","7.","","COB data is updated at least annually.","drop down box"]
["","8.","","The claims system automatically screens for duplicate bills.","drop down box"]
[null,"9.",null,"How are retroactive terminations handled and what is your process for collecting and crediting any claims that were paid after termination?","text"]
["","10.","","List the location(s) of your claims processing center(s) that would be servicing County employees and the corresponding geographic areas/regions covered by the respective location.  Use the \"Explanation\" column and/or worksheet if you need more space."]
["","11.","a.","Claims Processing Center 1"]
["",null,null,"Location","text"]
["",null,null,"Geographic Region(s) Covered","text"]
[null,null,"b.","Claims Processing Center 2"]
["","",null,"Location","text"]
["","",null,"Geographic Region(s) Covered","text"]
["","12.","","For the claims office that will service the County, what was the claims financial accuracy rate during 2018?","percentage, 1"]
["","13.","","For the claims office that will service the County, what was the claims financial accuracy rate during 2019?","percentage, 1"]
["","14.","","For the claims office that will service the County, what was the claims procedural error rate during 2018?","percentage, 1"]
["","15.","","For the claims office that will service the County, what was the claims procedural error rate during 2019?","percentage, 1"]
["","16.","","What is the target claim error rate for the office that would process claims for County?"]
["","","a.","% financial accuracy","percentage, 1"]
["","","b.","% procedural accuracy","percentage, 1"]
["","17.","","For the 2019 plan year, the average and target turnaround times for clean claims for the office that would process claims for the most County members are:"]
["","","a.","4 Calendar Days"]
["","",null,"Current Average %","percentage, 1"]
["","",null,"Target %","percentage, 1"]
["","","b.","7 Calendar Days"]
["","",null,"Current Average %","percentage, 1"]
["","",null,"Target %","percentage, 1"]
["","","c.","10 Calendar Days"]
["","",null,"Current Average %","percentage, 1"]
["","",null,"Target %","percentage, 1"]
[]
["VIII",null,null,"Reporting"]
["","1.","","Are the standard management reports available in real-time and on-line via the internet?","drop down box"]
["","2.","","Can these reports be customized to further meet the County's needs?","drop down box"]
["","3.","","If so, is there an additional charge for customized reports?","drop down box"]
[null,"4.",null,"Claims data will be provided electronically","drop down box"]
["","",null,"Monthly Reports"]
["","5.",null,"Monthly reporting containing the following information:"]
["",null,"a.","Paid Claims - separated by actives, retirees, etc.","drop down box"]
[null,null,"b.","Capitation (if applicable)","drop down box"]
[null,null,"c.","Administrative/Network Fees","drop down box"]
[null,null,"d.","Premiums (if applicable)","drop down box"]
["",null,"e.","Monthly Enrollment Counts - separated by actives, retirees, etc.","drop down box"]
[null,null,"f.","Lag Report - 36 months, separated by actives, retirees, etc.","drop down box"]
["","",null,"Annual Reports"]
["","6.",null,"Annual reporting containing the following information"]
[null,null,"a.","Executive summary report","drop down box"]
["",null,"b.","Claim utilization report","drop down box"]
["",null,"c.","Claim denials by reason","drop down box"]
[null,null,"d.","Claims paid expense summary","drop down box"]
[null,null,"e.","Utilization and cost analysis by specialty (i.e., GFD, Endodontists, Oral Surgeons, Periodontists, Prosthodontists, Orthodontists) ","drop down box"]
[null,null,"f.","Performance objectives compared to metrics","drop down box"]
[null,null,"g.","Network changes","drop down box"]
[null,"7.",null,"A year-end financial accounting for the program within 30 days of the contract anniversary date.","drop down box"]
[null,"8.","","Annual claim utilization reports containing the following information: "]
[null,null,"a.","Claims report by category (preventive, basic, major, orthodontia)","drop down box"]
[null,null,"b.","In-network vs. out-of-network utilization","drop down box"]
[null,null,"c.","Network savings reports for each network offered","drop down box"]
[null,null,"d.","Final discounts achieved by area","drop down box"]
[null,null,"e.","Payment reductions due to network negotiated rates","drop down box"]
[{"$nulls":3},"Audits and Systems - Dental","Answer Format","Response","Explanation"]
[null,"9.",null,"The County reserves the right to conduct audits.  Any third party auditor engaged by the County shall execute a confidentiality agreement in a form mutually agreed upon prior to conducting any audit ensuring that all information reviewed during such audit and all details will be treated as confidential and will not be revealed in any manner or form by or to any third party.\nConfirm you agree with each of the following:"]
[null,null,"a.","An independent consultant, on behalf of the County, will conduct a quality review of the dental plan designs to be loaded in the claims system(s) prior to implementation (or as soon thereafter as reasonably possible). As the selected Offeror, your organization agrees to pay the cost of this review (up to $35,000).  Your organization will provide all necessary support to enable the independent consultant, on behalf of the County, to review claims in a test environment that mirrors the plan information present in the \"live\" claims processing system. If this review cannot be supported remotely and requires an on-site review, your organization will be responsible for travel costs up to $5,000.  All costs associated with this review shall not be included in the County's retention fee. ","Drop down box"]
[null,null,"b.","An independent consultant, on behalf of the County, will conduct a dental claims audit, one of each every two years.  As the selected Offeror or administrator, your organization agrees to pay the cost of these audits (up to $45,000 each). Your organization will provide all necessary support to enable the independent consultant, on behalf of the County, to review the claims data. If this review cannot be supported remotely and requires an on-site review, your organization will be responsible for travel costs up to $5,000 (in addition to the $45,000).  All costs associated with this review shall not be included in the County's retention fee. ","Drop down box"]
[null,null,"c.","Right to audit at no charge except as a direct pass-through of any data retrieval fees, which may be required if data requested has already been stored.","Drop down box"]
[null,null,"d.","Right to audit post termination, up to two years following termination of the business relationship with prior written notification. The   County will not be held responsible for time or miscellaneous costs incurred by the dental plan in association with audit including, but not limited to, the costs associated with providing audit reports, systems access, or space.","Drop down box"]
[null,null,"e.","Right to audit more than once per year if the audits are different in scope or for different services.","Drop down box"]
[null,null,"f.","Right to perform additional audits during the year of similar scope if requested as a follow-up to ensure significant/material errors found in an audit have been corrected and are not recurring or if additional information becomes available to warrant further investigation.","Drop down box"]
[null,null,"g.","If your organization fails an audit, your organization will fund a re-audit at its own expense.","Drop down box"]
[null,null,"h.","Your organization agrees to provide reasonable cooperation with requests for information, which includes but is not limited to the timing of the audit, deliverables, data/information requests and Offeror response time to questions during and after the process.  Offeror will also provide a response to all “findings” it receives within 30 days, or at a later date if mutually determined to be more reasonable based on the number and type of findings.","Drop down box"]
[null,null,"i.","Your organization agrees to pay the Plan 100% of any overpayments made by the Plan as determined from an audit by a organization that the Plan chooses, and no later than 30 days after both parties have agreed to the recoveries, subject to a compounding interest penalty of 1% per month. ","Drop down box"]
[null,null,"j.","As a result of an audit, the County can set a time limit for pursuing underpayments/overpayments to/from its members.","Drop down box"]
[null,null,"k.","Your organization will allow County, or any other party selected by County (e.g. State Auditor General or County's independent auditors), to audit claims at any time, including, but not limited to, dental claim financial payments.  This would be in addition to any annual claims audit that County performs through contract with a organization for independent auditing services.","Drop down box"]
[null,null,"l.","Your organization will reimburse County for payments not authorized under the plan.  If not, explain why your organization is unwilling to agree to this request.","Drop down box"]
[null,null,"m.","Your organization is held accountable for the integrity of the financial transactions.","Drop down box"]
[null,"10.",null,"Confirm there would be no limit to the number of claims/discrepancies reviewed by the County’s auditor and vendor.","Drop down box"]
[null,"11.",null,"Each and every payment by Client to the vendor, whether representing fees, claims or otherwise, would be subject to audit and reconciliation and no such payment made by Client would constitute a waiver of its right to audit or reconcile. ","Drop down box"]
[null,"12.",null,"If the audit identifies confirmed errors, you will provide service warranty reports to auditor for every confirmed error.","Drop down box"]
[null,"13.",null,"You will review the service warranty with auditor and the County for final approval. Any claim errors identified in an audit, should include details of the error, how it was corrected and provide quantification of the overall impact of the error.","Drop down box"]
[null,"14.",null,"Issues identified in an external audit will not be used to offset amounts due back to the County or to members.","Drop down box"]
[null,"15.",null,"If you require the County to change claim platforms, you will allow the County to conduct a pre-migration readiness assessment and claim audit in order to test that the set up and benefits will be processed correctly.  The cost of the migration audit will be paid for by your organization.","Drop down box"]
[]
["IX",null,null,"Customer Service"]
[null,"1.","","Each new member receives a member handbook or other relevant member materials that describes grievance procedures.","drop down box"]
[null,"2.","","Network management requires that each dentist accommodate an appointment request within three weeks.","drop down box"]
[null,"3.","","List the location(s) of your call center(s) that would be servicing County employees and the corresponding geographic areas/regions covered by the respective location.  Use the \"Explanation\" column and/or worksheet if you need more space."]
[null,null,"a.","Call Center 1"]
[null,"",null,"Location","text"]
[null,"",null,"Geographic Region(s) Covered","text"]
[null,null,"b.","Call Center 2"]
[null,"",null,"Location","text"]
[null,"",null,"Geographic Region(s) Covered","text"]
[null,"4.","","There is a single toll-free, customer service telephone number for addressing claims payment, member services and any appeals.","drop down box"]
[null,"5.","","How many languages does the call center that will service County employees support?  Please list in the \"Explanation\" column.","number, 0"]
[null,"6.","","Will you provide a designated individual or staff responsible for resolving claim disputes or other issues?","drop down box"]
[null,"7.","","Are all incoming calls logged, tracked, recorded?","drop down box"]
[null,"8.","","For the customer service office that will serve the County, during the 2019 plan year, the member services telephone abandonment rate was 5% or less.","drop down box"]
[null,"9.","","For the customer service office that will serve the County, during the 2019 plan year, at least 90% of telephone calls to member services were answered within 20 seconds","drop down box"]
[null,"10.","","For the customer service office that will serve the County, during the 2019 plan year, 90% or more of new members received their ID cards by the effective date of coverage.","drop down box"]
[null,"11.","","What are the hours (include day and time zone) that a member can access a \"live\" customer service representative?","text"]
[null,"12.","","Can participants access information via an interactive Voice Response system available 24/7?","drop down box"]
[null,"13.","","Provider Directories:"]
[null,null,"a.","Have special notations for dentist no longer accepting new patients","drop down box"]
[null,"","b.","Provide a toll free number for continuous updates and updated provider directories","drop down box"]
[null,"","c.","Are available via the Internet","drop down box"]
[null,"14.","","Can dental network members access emergency care 24 hours a day, 7 days a week via a national toll-free number?","drop down box"]
[null,"15.","","Can you accommodate dependents who attend college away from home?","drop down box"]
[null,"16.",null,"How are out-of-area dental emergencies handled?","text"]
[null,"17.",null,"How is work in progress treated for a patient who elects to participate in the dental plan? What happens to work in progress when coverage is terminated?","text"]
["X",null,null,"Online Capabilities"]
[{"$nulls":3},"Website Capabilities"]
[{"$nulls":3},"Please identify which of the following services are currently available to members on your website."]
[null,"1.",null,"Update eligibility or change/add dependents.","drop down box"]
[null,"2.",null,"Optimize website for viewing/use from mobile device","drop down box"]
[null,"3.",null,"Ability to view forms (claim, prior authorization, etc.)","drop down box"]
[null,"4.",null,"Request additional or replacement ID cards.","drop down box"]
[null,"5.",null,"Print ID cards directly from site.","drop down box"]
[null,"6.",null,"View current and historical claims","drop down box"]
[null,"7.",null,"Take a oral health risk assessment.","drop down box"]
[null,"8.",null,"Provider directories (standard).","drop down box"]
[null,"9.",null,"Provider quality information.","drop down box"]
[null,"10.",null,"Provider cost information.","drop down box"]
[null,"11.",null,"Web chat feature","drop down box"]
[null,"12.",null,"Send an email to customer services","drop down box"]
[null,"13.",null,"Provider selection where users enter search criteria.","drop down box"]
[null,"14.",null,"Request determination of coverage ","drop down box"]
[null,"15.",null,"Treatment cost estimator","drop down box"]
[null,"16.",null,"Plan design and coverage information","drop down box"]
[null,"17.",null,"Oral health and wellness resources and education materials","drop down box"]
[null,"18.",null,"Ability to run reports to analyze healthcare spending","drop down box"]
[{"$nulls":3},"Please specify the tools available to the County via the employer portal of your company's website."]
[null,"19.",null,"Secure access to financial information for the County.","drop down box"]
[null,"20.",null,"Real-time eligibility maintenance","drop down box"]
[null,"21.",null,"Access to claims data.","drop down box"]
[null,"22.",null,"Access to member-specific coverage and enrollment information.","drop down box"]
[null,"23.",null,"Account level delegate rights.","drop down box"]
[null,"24.",null,"Eligibility verification.","drop down box"]
[null,"25.",null,"Generate electronic versions of member ID cards","drop down box"]
[null,"26.",null,"Employer ability to generate on-demand reports regarding claims costs, membership","drop down box"]
[null,"27.",null,"Ability to create custom reports for the employer ","drop down box"]
[null,"28.",null,"Ability to provide utilization data from employer website","drop down box"]
[null,"29.",null,"Access to standard forms (e.g., claims reimbursement) via the employer portal","drop down box"]
[{"$nulls":3},"Mobile Application Capabilities"]
[null,"30.",null,"Text message alerts","drop down box"]
[null,"31.",null,"Appointment reminders","drop down box"]
[null,"32.",null,"Ability to download forms (claim, prior authorization, etc.)","drop down box"]
[null,"33.",null,"Ability to view ID card  (the point of the mobile app is so you don't have to carry around a printed card.)","drop down box"]
[null,"34.",null,"Access to claims data","drop down box"]
[null,"35.",null,"Ability to track deductibles, out of pockets, and any other maximums","drop down box"]
[null,"36.",null,"Find a provider","drop down box"]
[null,"37.",null,"Ability to obtain provider cost information","drop down box"]
[null,"38.",null,"Ability to obtain provider quality information","drop down box"]
[null,"39.",null,"Is customer service chat available through the mobile app","drop down box"]
[]
["XI",null,null,"Performance Guarantees"]
[{"$nulls":3},"The County is willing to negotiate performance standards on financial and service performance results with the selected Offeror to encourage the Offeror to provide superior performance.  Failure to meet the performance guarantee(s) would result in a financial penalty.  The guarantees (with the exception of the implementation guarantees) are expected to occur each year, for the life of the contract.  Please indicate your concurrence below."]
[null,"1.",null,"Confirm your willingness to put 15% of ASO fee at risk each year on Account Management, Customer Service, Claim administration excludes implementation)","drop down box"]
[null,"2.",null,"You agree to provide quarterly reports to validate compliance with the service and performance guarantees.  Reports will be provided automatically without a written request requirement.","drop down box"]
[null,"3.",null,"You agree to allow the County the flexibility to allocate in writing the total amount at risk among the various performance categories at least 90 days prior to the start of each contract year.","drop down box"]
[null,"4.",null,"You agree that the guarantees will be measured and reconciled on a quarterly basis within 45 days from the close of the quarter, with the exception of annual guarantees which will be measured and reconciled within 45 days from the close of the year.  All performance guarantees will be audited on a scheduled basis. ","drop down box"]
[null,"5.",null,"You agree that penalties will automatically be paid annually within 75 days of the close of the measurement period without any written request requirement.","drop down box"]
[null,"6.",null,"You agree that all performance guarantees must be measured and reported on the County plans' specific data, not book of business.","drop down box"]
[null,"7.",null,"Should you require the County to migrate adjudication platforms or service facilities, you will guarantee that the County will be satisfied with the migration. Satisfaction will be measured as \"satisfied\" or \"not satisfied\". This will be a separate, stand-alone performance guarantee. The amount at risk will be equal to 30% of the combined total amount at risk for all other ongoing performance guarantees.","drop down box"]
[null,"8.",null,"You will agree to pay any performance guarantees regardless of the status of an executed contract or subsequent amendments.","drop down box"]
[null,"9.",null,"You will measure, report and pay implementation guarantees within 120 calendar days after implementation.","drop down box"]
[{"$nulls":3},"Account Management","Format Type","Response","Explanation"]
[null,"10.",null,"County Satisfaction Survey - Account Management Satisfaction - At least a 4.0 on a scale of 1 to 5 (with 5 being the best) on an annually satisfaction survey.\n\nDesignated members of the County's staff will complete an annual report card to evaluate Offeror account team, or the overall service performance. Guarantee will be measured using a mutually agreed upon survey tool. Scorings can be pass/fail or based on a rating such as: \n\n5 = Outstanding\n4 = Commendable\n3 = Satisfactory\n2 = Needs improvement\n1 = Unacceptable\n\nOfferor shall be responsible for survey design, data collection, analysis and all costs associated with conducting the surveys. The account team is typically scored on:  \n\nTechnical knowledge\nAccessibility and Responsiveness\nInterpersonal Skills\nCommunication Skills\nOverall Performance                     ","drop down box"]
[{"$nulls":3},"Member Services","Answer Format","Response","Explanation"]
[null,"11.",null,"Member services will include the following potential metrics"]
[null,null,"a.","99% of telephone calls to member services will be answered within 15 seconds; 100% within an average of 30 seconds.","drop down box"]
[null,null,"b.","Average abandonment rate will not exceed 2%.","drop down box"]
[null,null,"c.","First Call Resolution - 92% of inquiries will be resolved during first call","drop down box"]
[null,null,"d.","95% of telephone calls will be resolved within 5 business days.","drop down box"]
[null,null,"e.","90% of email inquires will be responded to within 24 hours","drop down box"]
[{"$nulls":3},"Claims Administration","Answer Format","Response","Explanation"]
[null,"12.",null,"Claims administration will include the following potential metrics"]
[null,null,"a.","Claims payment financial accuracy for the County's plans will be at least 99.5%.","drop down box"]
[null,null,"b.","Claims payment procedural accuracy for the County's plans will be at least 98.5%.","drop down box"]
[null,null,"c.","95% of claims will be processed within 10 business days; 99% of claims will be processed within 30 business days and 100% within 45 business days.","drop down box"]
[null,null,"d.","95% of adjusted claims will be turned around within 5 business days.","drop down box"]
[{"$nulls":3},"Implementation","Answer Format","Response","Explanation"]
[null,"13.",null,"Program will be operational by agreed upon date, to the satisfaction of the County.  This includes the steps below.","drop down box"]
[null,null,"a.","Implementation Tasks - Those tasks with deliverable dates, necessary to satisfactorily install the program by the effective date, will be clearly defined no later than 210 days prior to the effective date.","drop down box"]
[null,null,"b.","Production and distribution of ID cards prior to effective date","drop down box"]
[null,null,"c.","Eligibility Loading- Initial implementation electronic eligibility files will be loaded ","drop down box"]
[null,null,"d.","Meet or exceed the County's subjective assessment of satisfaction with program implementation.","drop down box"]
[null,null,"e.","Plan Designs Loaded - The claim system and benefit reference tool utilized by service and claims representatives will be accurately updated on the effective date of the plan","drop down box"]
[null,"14.",null,"Specify the Amount at Risk for Implementation","dollar"]
[null,"15.",null,"Pre-Implementation Audit - You will guarantee that the pre-implementation audit will be completed, including follow up test claims, at least 15 days prior to the effective date as long as the  County has signed off on the benefit set-up at least 75 calendar days prior to the effective date.  ","drop down box"]

{"sheet":"Explanation","index":2,"n_rows":9,"n_cols":2,"rows_kept":9,"merged":[[0,0,0,7],[4,0,4,1]]}
["Request for Dental Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["Explanations"]
[]
["This worksheet should be used to provide additional explanations for any questions for which a \"See Explanation\" response was given.  Explanations must be numbered to correspond to the question to which they pertain and they must be brief."]
[]
["State the worksheet/section/question number."]
[]
["Worksheets/ Section/  Question Number","Explanation"]

{"sheet":"Plan Design Instructions","index":3,"n_rows":7,"n_cols":3,"rows_kept":7,"merged":[[4,0,4,1]]}
[{"$f":"Explanation!A1","v":"Request for Dental Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["County Plan Designs"]
[]
["A summary of the County's plans' benefits is provided in this workbook under separate tabs.  Review each and indicate your ability to administer the current plan design. ",null,"If you are able to administer all existing benefits with no changes or deviations, you may simply confirm that here.  Otherwise, complete the applicable Agency Plan Design Deviations worksheets"]
["For additional benefit information, please see: ",null,"Confirm below:"]
["County","Attached plan documents","<Select>"]

{"sheet":"Standard Plan Design","index":4,"n_rows":59,"n_cols":7,"rows_kept":59,"merged":[[6,1,6,2],[6,3,6,6],[8,1,8,2],[13,1,14,1],[13,2,14,2],[15,1,16,1],[15,2,16,2],[17,1,18,1],[17,2,18,2],[19,1,20,1],[19,2,20,2],[21,1,22,1],[21,2,22,2],[23,1,24,1],[23,2,24,2],[25,1,26,1],[25,2,26,2],[27,1,28,1],[27,2,28,2],[30,1,31,1],[30,2,31,2],[32,1,33,1],[32,2,33,2],[34,1,35,1],[34,2,35,2],[36,1,37,1],[36,2,37,2],[38,1,39,1],[38,2,39,2],[40,1,41,1],[40,2,41,2],[42,1,43,1],[42,2,43,2],[44,1,45,1],[44,2,45,2],[47,1,48,1],[47,2,48,2],[49,1,50,1],[49,2,50,2],[51,1,52,1],[51,2,52,2],[53,1,54,1],[53,2,54,2],[55,1,56,1],[55,2,56,2],[57,1,58,2]]}
[{"$f":"'Premium Plan Design'!A1","v":"Request for Dental Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["County Plan Design"]
[]
["Please list any plan deviations below. Please also indicate by \"+\" if the plan deviation is an enhancement or \"-\" if a reduction."]
[{"$f":"'Premium Plan Design'!A6","v":"For additional benefit information, please see attached plan documents"}]
[null,"Standard Plan",null,"Vendor Plan Deviations"]
["Services"," In-Network  "," Out-of-Network  "," In-Network  ","\"+\" or \"-\""," Out-of-Network  ","\"+\" or \"-\""]
["Maximum Annual Benefit","$1,500 per enrollee, per calendar year"]
["Annual Deductible"]
["Diagnostic ","None","None"]
["Basic & Major\n","$55 per person","$110 per person"]
["Diagnostic\n\n"]
["Oral Exams","100%\n","100%\n"]
["Twice in a calendar year."]
["Periodontal/Regular cleanings","100%\n","100%\n"]
["Limited to four in a calendar year (maximum of 2 regular cleanings)."]
["Fluoride applications","100%\n","100%\n"]
["Twice in a  calendar year for enrollees under the age of 19."]
["Bitewing X-rays","100%\n","100%\n"]
["Bitewing X -rays are limited to twice in a\ncalendar year limited to a maximum of 4 films or a set (7-8 films) of vertical bitewings.\n"]
["Full mouth/panelipse X-rays","100%\n","100%\n"]
["Once in a 3-year period."]
["Sealants","100%\n","100%\n"]
["One application per tooth for  enrollees  under the age of 16 on non-carious, non-restored 1st and 2nd permanent molars"]
["Space maintainers","100%\n","100%\n"]
["Once per quadrant per arch for enrollees under the age of 14."]
["Consultation ","100%\n","100%\n"]
["One consultation per consultant Cother than the attending dentist per calendar year)."]
["Basic\n"]
["Amalgam (silver) and composite (white) filings","80% after deductible","80% after deductible"]
["Primary (baby) teeth for enrollees under the age of 14."]
["Stainless steel crowns","80% after deductible","80% after deductible"]
["Primary (baby) teeth for enrollees under the age of 14."]
["Simple extractions","80% after deductible","80% after deductible"]
["Primary (baby) teeth for enrollees under the age of 14."]
["Endodontic services/root canal therapy ","80% after deductible","80% after deductible"]
["Retreatment only after 24 months from initial root canal therapy treatment."]
["Complex oral surgery ","80% after deductible","80% after deductible"]
["Surgical extractions and other surgical procedures."]
["Denture repair and recementation of crowns, bridges and dentures","80% after deductible","80% after deductible"]
["Once in a 12-month period after 6 months from initial placement."]
["General Anesthesia","80% after deductible","80% after deductible"]
["When rendered in conjunction with a covered oral surgery procedure or when medically necessary."]
["Therapeutic Drug Injection","80% after deductible","80% after deductible"]
["Injectable drugs administered by a dentist for therapeutic reasons."]
["Major "]
["Periodontic services","50% after deductible","50% after deductible"]
["Once per quadrant in a 24-36 month period based on services rendered."]
["Crowns","50% after deductible","50% after deductible"]
["Once per tooth in a 60-month period for enrollees age 12 and older."]
["Prosthodontics, removable and fixed","50% after deductible","50% after deductible"]
["Once in a 60-month period for enrollees age 16 and older."]
["Implants","50% after deductible","50% after deductible"]
["Once per site for enrollees age 16 and older."]
["Orthodontic Services","50% \nof allowed benefit","50% \nof allowed benefit"]
["Treatment for the proper alignment of teeth for dependent children under the age of 19"]
["Orthodontia Lifetime Maximum","$2,500 per person"]
["For subscriber and covered dependents."]

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[{"$f":"'Plan Design Instructions'!A1","v":"Request for Dental Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["County Plan Design"]
[]
["Please list any plan deviations below. Please also indicate by \"+\" if the plan deviation is an enhancement or \"-\" if a reduction."]
["For additional benefit information, please see attached plan documents"]
[null,"Premium Plan",null,"Vendor Plan Deviations"]
["Services"," In-Network  "," Out-of-Network  "," In-Network  ","\"+\" or \"-\""," Out-of-Network  ","\"+\" or \"-\""]
["Maximum Annual Benefit","$2,500 per enrollee, per calendar year\n(applies to Basic and Major Services)"]
["Annual Deductible"]
["Diagnostic\n\n","None","None"]
["Basic & Major","$55 per person","$110 per person"]
["Diagnostic\n\n"]
["Oral Exams","100%\n","100%\n"]
["Twice in a calendar year."]
["Periodontal/Regular cleanings","100%\n","100%\n"]
["Limited to four in a calendar year (maximum of 2 regular cleanings)."]
["Fluoride applications","100%\n","100%\n"]
["Twice in a  calendar year for enrollees under the age of 19."]
["Bitewing X-rays","100%\n","100%\n"]
["Bitewing X -rays are limited to twice in a\ncalendar year limited to a maximum of 4 films or a set (7-8 films) of vertical bitewings.\n"]
["Full mouth/panelipse X-rays","100%\n","100%\n"]
["Once in a 3-year period."]
["Sealants","100%\n","100%\n"]
["One application per tooth for  enrollees  under the age of 16 on non-carious, non-restored 1st and 2nd permanent molars"]
["Space maintainers","100%\n","100%\n"]
["Once per quadrant per arch for enrollees under the age of 14."]
["Consultation ","100%\n","100%\n"]
["One consultation per consultant Cother than the attending dentist per calendar year)."]
["Basic (Class II)\n"]
["Amalgam (silver) and composite (white) filings","90% after deductible","90% after deductible"]
["Primary (baby) teeth for enrollees under the age of 14."]
["Stainless steel crowns","90% after deductible","90% after deductible"]
["Primary (baby) teeth for enrollees under the age of 14."]
["Simple extractions","90% after deductible","90% after deductible"]
["Primary (baby) teeth for enrollees under the age of 14."]
["Endodontic services/root canal therapy ","90% after deductible","90% after deductible"]
["Retreatment only after 24 months from initial root canal therapy treatment."]
["Periodontic services","90% after deductible","90% after deductible"]
["Once per quadrant in a 24-36 month period based on services rendered."]
["Complex oral surgery ","90% after deductible","90% after deductible"]
["Surgical extractions and other surgical procedures."]
["Denture repair and recementation of crowns, bridges and dentures","90% after deductible","90% after deductible"]
["Once in a 12-month period after 6 months from initial placement."]
["General Anesthesia","90% after deductible","90% after deductible"]
["When rendered in conjunction with a covered oral surgery procedure or when medically necessary."]
["Therapeutic Drug Injection","90% after deductible","90% after deductible"]
["Injectable drugs administered by a dentist for therapeutic reasons."]
["TMJ","90% after deductible","90% after deductible"]
[]
["Occlusal guard (bruxism)","90% after deductible","90% after deductible"]
["Limited to one in a 60-month period"]
["Major (Class III)"]
["Crowns","60% after deductible","60% after deductible"]
["Once per tooth in a 60-month period for enrollees age 12 and older."]
["Prosthodontics, removable and fixed","60% after deductible","60% after deductible"]
["Once in a 60-month period for enrollees age 16 and older."]
["Implants","60% after deductible","60% after deductible"]
["Once per site for enrollees age 16 and older."]
["Orthodontic Services (Class V)","50% \nof allowed benefit","50% \nof allowed benefit"]
["Treatment for the proper alignment of teeth"]
["Orthodontia Lifetime Maximum","$2,500 per person"]
["For subscriber and covered dependents."]

{"sheet":"Geo Access","index":6,"n_rows":5,"n_cols":1,"rows_kept":5,"merged":[[4,0,4,9]]}
[{"$f":"'Standard Plan Design'!A1","v":"Request for Dental Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["Geo Access"]
[]
["To obtain the Geo Access instructions, you will need to request from Aon's NAPD team at hnapdmbx@aon.com. Please follow the workflow requested in the e-mail outlined by the NAPD team.  "]

{"sheet":"Disruption","index":7,"n_rows":5,"n_cols":1,"rows_kept":5,"merged":[[4,0,4,9]]}
[{"$f":"'Geo Access'!A1","v":"Request for Dental Proposal (RFP) for Arlington County Government"}]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["Provider Disruption"]
[]
["To obtain the Proovider Disruption instructions, you will need to request from Aon's NAPD team at hnapdmbx@aon.com. Please follow the workflow requested in the e-mail outlined by the NAPD team.  "]

{"sheet":"Plan Documents","index":8,"n_rows":6,"n_cols":1,"rows_kept":6}
["Request for Dental Proposal (RFP) for Arlington County Government"]
["RFP No. 21-HRD-RFP-141 Dental Plan"]
["Plan Documents"]
[]
[]
["See Attachment J"]